Updated !! Is this mssounding symptoms?

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Updated !! Is this mssounding symptoms?

Postby froggygirl23 » Fri Aug 11, 2006 9:21 am

any ideas to throw out there would be helpful.
Doctors seen: family doctor (once) neurologist (twice) and internal medicine (once)

Symtoms: All the time dizziness, (for the past 2 1/2 months)
weakness all over.
Weakness in hands and feet that comes and goes. Tingling in fingers.
Sweating for no reason.
Swallowing trouble (clearing throat alot after eating meals & feels like there is something in the throat all the time),
restless legs syndrome symptoms,
numbness has had two bouts in right side of face/head, and some more numbness in face to a lesser degree.
Also is tired often, doesn't sleep or eat well, has a physically demanding full time job, has been off work for a month with no improvement.
Has has memory problems also for about 3 months or so.
Feels like he's in a fog
He stumbles frequently

THE dizziness and weakness is the major problems.

Tests done: MRI normal
ECG normal except bpm was 104,
2 blood tests, (first one had high monocytes and low white blood count, second test a month later the wbc was in normal range, but had slightly elevated liver ensyme alt was 74 and high protein.
Had a nerve conduction test also, which was normal...


Does this sound like it could be MS? His first doctor told him it did, but after one clear MRI everyone quit talking about it. The internal medicine doctor said she felt like he caught something viral and that he should be getting over it any day, and to come back in two weeks if he's still having trouble. :( He's still not better and it's been almost two weeks.
Last edited by froggygirl23 on Tue Aug 15, 2006 3:55 pm, edited 2 times in total.
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Postby froggygirl23 » Fri Aug 11, 2006 9:22 am

He can't drive he is so dizzy but it's not vertigo.
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Postby amelia » Fri Aug 11, 2006 10:47 am

First of all, I AM NOT A DOCTOR. But my husband, Gary had clear MRI's for a long time. What you have described, yes, it can be MS. It also can be a lot of other things. Gary's diagnosis was a matter of knocking out everything else. Then he was diagnosised with "clinical" MS. Meaning if it walks, talks, and looks like a duck, then it must be a duck. One thing I see with MS symptoms is what they call hyper relexes. When you do the knee reflex thing, does it jump more than it really should? Also, bumping the elbow area is a reflex check also. The symptom that nailed Gary's MS was Optic Neuritis. That is blindness in the eye caused by immflamation of the optic nerve. Hope this helps some. Unfortunately, MS does not always show up in test. Not even the specified MS test.
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Postby jimmylegs » Fri Aug 11, 2006 6:45 pm

definitely neuropathy, but as amelia says that can be for many reasons. i believe there are a few ppl here who have had clear mri and still have problems that have been labelled ms, anyone else want to jump in here?

i'm not a doctor of any kind and without knowing more about the bloodwork - and his history re diet, medication, lifestyle, infection, and hereditary issues might be - i couldn't even make a properly educated guess what could be causing the problem. (aside: so i gather when they said high monocytes they meant relatively to other white blood cells? considering the overall wbc count was low?) obviously your own doctors would have considered the problem with a lot more background info available... but here's what i think given the info you've provided:

in a very general sense i was kind of leaning towards perhaps a peripheral neuropathy
http://en.wikipedia.org/wiki/Peripheral_neuropathy
as opposed to a central one like in ms. at first i thought the dizziness might be inconsistent but it's not once you consider the autonomic system - part of that is control over nerves supplying blood vessels -> body temperature and blood pressure (the sweating and dizziness issues?)
http://www.nlm.nih.gov/medlineplus/ency/article/000776.htm
i believe autonomic issues could be implicated in digestive problems too... perhaps an issue with the function of the esophagus.

the high liver enzyme indicates some damage i believe, which could mean your husband is having some problems processing nutrients, possibly due to a toxin, which is why i mentioned medication etc. - maybe cholesterol meds or some other harmful factor? the high protein seems to be supportive of that idea.

so maybe you can see something in that bit of reading that sets off some ideas. best wishes!
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couple other things:

Postby jimmylegs » Fri Aug 11, 2006 9:04 pm

hi the following info stood out for me, one because i do so much reading about nutrition, and two because you mentioned something about hubby's physically demanding job:

http://www.mayoclinic.com/health/periph ... DSECTION=4

"Your risk of developing peripheral neuropathy is also higher if you have one or more of the following risk factors:

Alcohol abuse. Excessive drinking of alcohol can affect your nervous system, causing numbness of your hands and feet.

Vitamin deficiency. A lack of certain vitamins, especially B-1 (thiamin) and B-12 makes peripheral neuropathy more likely. Pernicious anemia, which occurs when your body can't absorb B-12 properly, often leads to peripheral neuropathy.

Immune system disorders. You're more likely to develop peripheral neuropathy if you have an autoimmune disease, such as lupus or rheumatoid arthritis, or if your immune system is compromised by the human immunodeficiency virus (HIV) or AIDS.

Other health problems. Medical conditions, including certain types of cancer, kidney disease and liver disease, also can put you at risk of nerve damage.

Repetitive stress. A job or hobby that puts stress on one nerve for long periods of time increases your chances of developing peripheral neuropathy. In carpal tunnel syndrome, for example, the median nerve that extends through your wrist into your fingers becomes compressed. Repetitive assembly line work or work involving prolonged, heavy gripping can compress the median nerve. Playing golf, tennis or a musical instrument and using vibrating power tools or even crutches also can put pressure on peripheral nerves.

Toxic substances. Exposure to some toxic substances can make you susceptible to peripheral nerve damage. These substances include heavy metals, such as lead, mercury and arsenic; organic solvents; and certain medications, such as those used to treat cancer or AIDS.

also, here are two interesting studies i found on a cuban epidemic of peripheral neuropathy - i like that it highlights the importance of nutrition and also that it shows optic neuropathy in a peripheral/toxin/nutrient context.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7699385&dopt=Citation

J Neurol Sci. 1994 Dec 1;127(1):11-28.
An epidemic in Cuba of optic neuropathy, sensorineural deafness, peripheral sensory neuropathy and dorsolateral myeloneuropathy.
Roman GC.
Neuroepidemiology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD.

An epidemic outbreak of peripheral neuropathy affected Cuba in 1992-93 resulting in 50,862 cases (national cumulative incidence rate (CIR) 461.4 per 100,000). Clinical forms included retrobulbar optic neuropathy, sensory and dysautonomic peripheral neuropathy, dorsolateral myeloneuropathy, sensorineural deafness, dysphonia and dysphagia, spastic paraparesis, and mixed forms. For epidemiological purposes, cases were classified as optic forms (CIR 242.39) or peripheral forms (CIR 219.25). Increased risk was found among smokers (odds ratio (OR) 4.9), those with history of missing meals (OR 4.7) resulting in lower intake of animal protein, fat, and foods that contain B-vitamins, combined drinking and smoking (OR 3.5), weight loss (OR 2.8), excessive sugar consumption (OR 2.7) and heavy drinking (OR 2.3). Optic neuropathy was characterized by decreased vision, bilateral and symmetric central or cecocentral scotomata, and loss of color vision due to selective lesion of the maculopapillary bundles. Peripheral neuropathy was a distal axonopathy lesion affecting predominantly large myelinated axons. Deafness produced selective high frequency (4-8 kHz) hearing loss. Myelopathy lesions combined dorsal column deficits and pyramidal involvement of lower limbs with spastic bladder. Clinical features were those of Strachan syndrome and beriberi. Intensive search for neurotoxic agents, in particular organophosphorus esters, chronic cyanide, and trichloroethylene intoxication, yielded negative results. Treatment of patients with B-group vitamins and folate produced rewarding results. Most patients improved significantly and less than 0.1% of them remained with sequelae; there were no fatal cases. Supplementation of multivitamins to the entire Cuban population resulted in curbing of the epidemic. Overt malnutrition was not present, but a deficit of micronutrients, in particular thiamine, cobalamine, folate and sulfur amino acids appears to have been a primary determinant of this epidemic.

Rev Neurol. 1997 Dec;25(148):1848-52.
Comment in:
Rev Neurol. 1998 May;26(153):840.
[Clinical characteristics of Cuban epidemic neuropathy]
Gomez-Viera N, Rodriguez-Silva H, Perez-Nellar J, Telleria-Diaz A, Nassiff A, Marquez M, Caceres M, Rivero-Arias E.
Hospital Clinico Quirurgico Hermanos Ameijeiras, La Habana, Cuba.

INTRODUCTION: At the beginning of 1992 an epidemic neuropathy was seen in Cuba. MATERIAL AND METHODS: To determine the clinical characteristics we studied the clinical and neurological features, cerebrospinal fluid, and did neurophysiological investigations and sural nerve biopsies. RESULTS: Sixty patients were studied. Of these, 42 (70%) had polyneuropathy which was predominantly peripheral and 18 (30%) had combined forms. Most patients had asthenia and weight loss. The polyneuropathic effects were mainly in the legs. In 33.3% of the patients there were distal autonomic effects and sphincter disorders. Only 7 patients had hypoacusia. However, subclinical neurosensorial hypoacusia was seen in 33.3%. Optic neuropathy affected central vision bilaterally and symmetrically with temporal pallor of the papilla in half the cases. In 3 patients there was loss of ganglionar nerve fibres of the papillo-macula bundle. The contrast sensitivity visual test was abnormal in some patients with peripheral polyneuropathy, showing subclinical optic neuropathy in these cases. Sensory neuroconduction suggested axonal neuropathy in 30 patients, demyelinating neuropathy in 5 patients, while the remainder were normal. Motor neuroconduction was normal in most patients. Sural nerve biopsy of 27 patients showed axon damage in 96.2% of cases. CONCLUSIONS: The clinical picture is similar to that seen in nutritional deficiencies and toxic processes.
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Re: Is this ms sounding symptoms?

Postby NHE » Fri Aug 11, 2006 9:49 pm

froggygirl23 wrote:any ideas to throw out there would be helpful.

Has he had a spinal tap? This test can play an important role in the diagnoisis of MS as it will show if there are oligoclonal protein bands and an abnormally high white cell count in the CSF.

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Postby sh8un » Fri Aug 11, 2006 11:53 pm

Hi
I have to say that I did not read all of everyone's posts before I wrote this but I scanned them and I did not see any explanation for your test results. So here is what I know. Of course with any diagnostic procedure, you can not look at it on its own. You would need to look at the whole picture to get an idea of what you are dealing with. You can have a normal MRI and still have MS. It usually shows up on the MRI in a couple of years. A spinal tap would clear that up. On its own a low WBC could mean marrow failure, overwhelming infections, dietary deficiencies (b12, iron deficiency) and autoimmune disease. Is your husband on any chemo? When did he have the blood work done? WBC can be lower in the morning. It also depends on how low it is. There are also many drugs that can cause a decrease in WBC. Your husband's returned to normal and so that's great. I am putting this info up for anyone else that may have the same questions. Monocytes are elevated in the following: chronic inflammatory disorders, parasites, TB, chronic ulcerative colitis. The Elevated ALT could indicate liver disease. False elevations are due to some meds and IM injections. You also have to really look at how much the increase is. I am not familiar with the US measurements. I am not sure what you mean by elevated protein levels because I need to know which protein you are talking about. So like I said, this is what these tests mean on their own but you have to take a lot of other factors into consideration for the whole puzzle to come together. So I might have not really answered your questions at all.
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Naturally I wonder about mucous-insulin

Postby lyndacarol » Sat Aug 12, 2006 6:16 am

Froggygirl23--Once you get to know me you will not be surprised at my question: Does he have mucous for any reason--sinus drainage, allergies, sinus infections? I think there is a connection with that and excess insulin production....
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Postby froggygirl23 » Sat Aug 12, 2006 11:13 am

A little more information for all of you kind people that read this, Thank you. Extra thanks to those who responded.

He has not had a spinal tap yet. The neuro didn't want to to it until the internal medicine doctor looked him over good, in case it wouldn't be necessary. The MRI was of the brain only.

His history before he got sick was working at night, sleepin about 3 or 4 hours a day on average, eating once maybe twice a day. He would drink one or two beers a day.

He when first started getting sick he had blood work done, which showed an overall low wbc(3.9) normal is 4.2-10.8, but the monocytes were 17.5 H (normal range is between 2 and 10) As far as the protein goes, it just says "total protein" 8.6 H (the range is between 6 and 8.3) I put it was in the second test but was mistaken, it was in the first test.
Also Glucose was 115 H (normal between 75-100)

He stopped drinking any alcohol after the first blood test.

His doctor put him on Remeron for depression which he took for 2 weeks but had to stop. (He was having an adverse side effect with his mood) I have read that remeron can make liver trouble. The test that showed alt 74 H was a month after the first blood test and while he was on the medicine. I'm not sure if he would have been on it long enough for it to effect him that way.
Glucose 107 H (normal between 75-100)
TSH 0.59 was in the normal zone (0.47-4.68)

His reflexes were checked by the Neuro, she didn't comment on them. She also looked into his eyes and made a comment that they looked good.

The past 3 doctor visits his bpm has been 104, 104, & 100. The one in the middle he was falling asleep at the doctors visit, was very groggy and not at all nervous. His blood pressure was also on the low side.

The I.M. has another round of blood tests results that we are going to find out about Monday. He has also had a TB skin test that will be checked monday, and an x-ray on his chest that we still don't know the results for.

Also, his dizziness doesn't seem to get worse or better with standing, sitting, or another change in position.

His sinuses haven't bothered him in the past probably 6 months. But he usaully gets a bad sinus infection 2 to 3 times a year.

Jimmylegs: I read your link.
He does have sensitivity to touch. In fact it seems the lighter I touch him the more it bothers him. He has even made the comment of the fan hurting his skin (we use the noise to sleep) and could I please turn it the other way.

I don't think anyone has checked for heavy metal toxity... but perhaps that's one of the tests that will come back Monday.
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Tests

Postby lyndacarol » Sat Aug 12, 2006 4:27 pm

First, my personal story: My first two MRIs were normal; Evoked potentials normal, too; a test for heavy metals was done at Mayo Clinic in Rochester, MN...normal also! My MRIs now note (because I ask) there is severe sinusitis, though I suffer no pressure or pain, only constant sinus drainage.

Next, his...Ask that on the next MRI of his head particular note of his sinuses be made. With the symptoms involving dizziness (all the time for last 2 1/2 months, you say, and with a history of sinus infections) and the feeling of something in his throat all the time), I wonder if he, like me, has something going on there.

With his glucose results, I also suspect his pancreas is secreting extra insulin ("pedaling as fast as it can") in an effort to get the glucose level down. He might even be considered Insulin Resistent. Would his doctor order a "fasting serum insulin test"? (A result below 10 is best; mine was 12UU/ML) Or a non-fasting one? (Mine was 30, where the normal range is 6-27) I make these suggestions because I think insulin is the initial cause of most of the MS symptoms; but I am NOT a doctor--I have NO background in science!
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Postby amelia » Sat Aug 12, 2006 5:34 pm

A spinal tap would clear that up.

Not always there. Gary's showed nothing. At the time they were testing him, they used every method available. Eye evoked Response, MRI, Mylegram, CAT scans with dye and all the "do this and do that" test. Gary could not pass the "do your arms like this or your legs like this" I look back on it now and realize that the blind eye, we thought from a welding accident, and his hyper relexes is what was making them look closely at MS.
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Postby amelia » Sat Aug 12, 2006 5:35 pm

Also, somehting we learned about dizziness. If meclizine, antivert, does not stop the dizziness, then it is NOT typical inner ear problems. Gary's turned out to be MS.
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mclizine

Postby froggygirl23 » Sat Aug 12, 2006 6:22 pm

He had taken mclizine for 3 weeks and it never helped him.

How long did it take for Gary to be diagnosed?

He hasn't had an eye exam. Another question, is the neuro looking into his eyes good enough, or does he need an eye exam. He can't see very well, but that may be because his glasses are scratched and haven't had them replaced in over 4 years. (I don't wear glasses, so I don't know)
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hi froggy

Postby jimmylegs » Sun Aug 13, 2006 5:47 am

hi there, that one meal a day sounds highly suspect to me! he must be deficient across the board. alcohol sucks out b12 and b1 in particular, and both those are particularly important to the peripheral nerves, so if you're not getting enough from food and then throwing in a couple beers... maybe try a super b-complex, like a 150 or something, couple a day for a while? if he's only been eating one meal a day you shouldn't have to worry about getting too many b-vitamins for quite some time.
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Postby sh8un » Sun Aug 13, 2006 9:58 am

Hi Amelia
Wow...so much to learn about MS. Just wondering if it is a common thing to have a clear spinal tap and no MS??? Or was it possible that your husband just went on to develop MS coincidentally? Did your husnbad have an MRI and a tap? I always thought that if they don't see it in your brain or your spine that there would be a spinal tap and that would be it. I know that they check for oligoclonal bands (which most ppl with MS have) and other proteins. I just thought that lesions on MRI or the presence of disease activity had to be somewhere. Would love your input.
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